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Understanding infections in pregnancy

Highlights

Viral and bacterial infections can develop in anyone, but certain infections are more likely to occur in pregnant women. Pregnancy can also make infections more severe.

Most babies aren’t harmed when the mother acquires an infection. However, some infections can be transmitted to babies through the placenta or during birth. This can lead to complications in the baby.

The type and severity of the infection determine the best course of treatment. In some cases, treatment may not be needed. To help prevent infections in pregnancy, wash your hands regularly, be aware of food-borne illnesses, and practice safe sex.

Pregnancy is a normal and healthy
state that many women aspire to at some point in their lives. However, pregnancy
can make women more susceptible to certain infections. Pregnancy may also make
these infections more severe. Even mild infections can lead to serious illness
in pregnant women.

Some infections that occur during
pregnancy primarily pose a risk to the mother. Other infections can be
transmitted to the baby through the placenta or during birth. When this occurs,
the baby is at risk for health complications as well.

Some infections that develop during
pregnancy can lead to miscarriage, preterm labor, or birth defects. They may
even be life-threatening for the mother. To complicate matters, the medications
used to treat infections can cause serious side effects, especially for the baby.
It’s important to try to prevent infections in pregnancy to minimize risks to both
mother and baby.

Why pregnant women are more
susceptible to infection

Pregnancy affects every
system in your body. Changes in hormone levels and immune system function can
make you more vulnerable to infections and serious complications. Labor and
delivery are especially susceptible times for both you and your baby.

Changes in immunity

The immune system defends the body
against harmful invaders. It fights against everything from bacteria to cancer
cells to transplanted organs. A complex collection of players works together to
identify and eliminate foreign intruders.

During pregnancy, your immune system
changes so that it can protect both you and your baby from disease. Different
parts of your immune system are enhanced while others are suppressed. This
creates a balance that can prevent infection in the baby without compromising
the health of the mother.

These changes also help protect your
baby from your body's defenses. In theory, your body should reject the baby as
“foreign,” but it doesn’t. Similar to an organ transplant, your body sees your
baby as part "self" and part "foreign." This keeps your
immune system from attacking the baby.

Despite these protective mechanisms,
you’re more prone to infections that don’t normally cause illness. During
pregnancy, your immune system has to work harder since it’s supporting two.
This makes you susceptible to certain infections.

Changes in
body systems

Aside from changes in immune
function, hormonal changes can also increase your risk for infection. These fluctuations
in hormone levels often affect the urinary tract, which is made up of:

the
kidneys, which are organs that produce urine

ureters,
which are tubes that carry urine from the kidneys to the bladder

bladder,
which is where urine is stored

urethra,
which is a tube that transports urine out of the body

As the uterus expands during
pregnancy, it puts more pressure on the ureters. Meanwhile, the body increases
the production of a hormone called progesterone, which relaxes the ureter and
bladder muscles. As a result, urine may stay in the bladder too long. This
increases your risk of developing a urinary tract infection. Hormonal
changes also make you more susceptible to a type of yeast infection known as candidiasis.
Higher levels of estrogen in the reproductive tract predispose you to yeast
infections.

Additionally, changes in the amount of
fluid in the lungs can raise your risk for lung infections, such as pneumonia. Your lungs
contain more fluid during pregnancy, and the increased amount of fluid puts
more pressure on the lungs and abdomen. This makes it harder for your body to
clear this fluid, causing the fluid to build up in the lungs. The extra fluid
stimulates bacterial growth and hinders your body's ability to resist
infection.

Risks for mother and baby

Risks for mother

Some infections that occur during
pregnancy pose problems primarily for the mother. These include urinary tract
infections, vaginitis, and postpartum infection.

Risks for baby

Other infections are particularly
troublesome for the baby. For example, cytomegalovirus,
toxoplasmosis,andparvovirus can all be transmitted from mother to baby. If this happens, it
may have serious consequences.

No effective treatment yet exists for
a cytomegalovirus infection that’s present at birth. Antibiotics are available
that may be able to treat toxoplasmosis successfully. Although there are no
antibiotics for parvovirus, the infection can be treated with intrauterine
blood transfusions.

Risks for both
mother and baby

Some infections are particularly
harmful to both mother and baby. These include:

Antibiotics are effective against
syphilis and listeria in the mother and baby, if the infection is diagnosed promptly.
Though there are no antibiotics for viral hepatitis, vaccines are now available
to help prevent hepatitis A and B infections.

HIV infection

An HIV infection during pregnancy is
a serious and potentially life-threatening problem. However, new multidrug
combinations now significantly prolong life span and improve the quality of
life for people with HIV. Along with cesarean delivery before the onset of labor,
these drug therapies have been remarkably effective in reducing the rate of
transmission of HIV infection from pregnant women to their babies.

Group B streptococcus

Doctors test every woman at the end
of pregnancy for GBS. This infection is caused by a common bacterium known as
group B streptococcus. According to the Centers
for Disease Control and Prevention, about 1 in 4 women carry a GBS
infection. This infection is most often transmitted during vaginal deliveries,
as the bacterium may be present in the mother’s vagina or rectum. In pregnant
women, the infection can cause internal inflammation and also stillbirth.
Newborns infected with GBS can develop serious and potentially life-threatening
infections. These include sepsis, pneumonia, and meningitis. When left
untreated, such infections can cause birth defects in the baby, including hearing
or vision loss, learning disabilities, and chronic mental impairments.

The importance of knowledge and ongoing care

The relationship between you and your
doctor is vital during your pregnancy. Knowing about the increased risk of
infection during pregnancy and the potential harm to you and your baby can help
you prevent transmission. Being aware of the different types of infection that
could arise also allows you to recognize the symptoms. If you become ill, receiving
a prompt diagnosis and effective treatment can often prevent complications. Make
sure to talk to your doctor about any concerns or questions you have during
pregnancy.

How to prevent infections in pregnancy

Infections in pregnancy are
preventable. Taking small, everyday precautions can go a long way in reducing
possible harm to you and your baby. To help prevent infections during your
pregnancy, you should:

Regularly
wash your hands with soap and water. This is especially important after
using the bathroom, preparing raw meat and vegetables, and playing with
children.

Cook
meats until they are well-done. Never eat undercooked meats, such as hot
dogs and deli meats, unless they are re-cooked until hot.

Don’t
consume unpasteurized, or raw, dairy products.

Don’t
share eating utensils, cups, and food with other people.

Avoid changing
cat litter and stay away from wild or pet rodents.

Practice
safe sex and get tested for sexually transmitted infections.

Make
sure your vaccinations are up-to-date.

Schedule an appointment with your
doctor right away if you’re sick or believe you’ve been exposed to a contagious
disease. The sooner an infection is diagnosed and treated, the better the outcome
for you and your baby.